The Medical School of the National Kapodistrian University of Athens opened a dialogue on the developments concerning the COVID-19 pandemic, holding an informative event today, where faculty members of the EKPA Medical School answered questions from the public about the disease, its prevention and treatment. .
Is covid a mild virus or not? Covid disease is not the common cold. About 80% pass the disease mildly, 15% have a serious illness and 5% extremely severe, said Pagona Lagiou, professor of Health and Epidemiology, director of the Laboratory of Health Epidemiology and Medical Statistics. Mortality is of the order of 2.3%.
He added, however, that there are large differences, with age predominating, which is the strongest risk factor. Comorbidities are also very important.
An extremely important factor that differentiates the severity of the disease is the vaccine. A vaccinated person is 11 times less likely to be hospitalized and 14 times less likely to die than someone who has not been vaccinated.
Nikolaos Sypsas, a professor of Pathological Physiology-Infectious Diseases, referred to the symptoms of covid-19, saying that we should not say that we have a simple cold, proposing a self-diagnostic test. Headache, runny nose, sneezing, pain, fatigue, are symptoms common to the common cold, so in view of the holidays, regardless of the vaccination or not, it is good to do a test, said Mr. Sypsas.
The most recognizable system that is affected is the respiratory system and the most serious complication is pneumonia and this is the cause of hospital admissions, said on his part Stylianos Loukidis, Professor of Pulmonology, 2nd Pulmonary Clinic, Attica University Hospital, President Hellenic Pulmonary Society. The question is whether pneumonia gives clinical symptoms recognizable by the patient, shortness of breath in fatigue and then it will occur even at rest or not. There are cases where one can have “silent hypoxemia”, ie the patient experiences low oxygen without feeling it. Here the use of the oximeter plays an important role, said the professor (measurement in both hands on the same finger for 20 seconds, with a limit of 94%), in order to find the patient with a problem in time.
Computed tomography was a key tool in the identification and extent of pneumonia. He added that the Delta mutation did not have the characteristic picture of “silent hypoxemia” as in the first pandemic waves, as it appeared clinically. Patients also experience a worsening of the initial waves, mainly because they feel that they can extend their stay at home, even though they see the disease progressing.
The children were referred to by Vasiliki Papaevangelou, professor of Pediatric Infectious Diseases, director of the DG Pediatric Clinic at the Attica University Hospital. A large percentage of children under the age of 10 have asymptomatic or mild symptoms that are difficult to distinguish from a common cold. Even when they show symptoms, they have fever, rhinitis, cough, sore throat, headache, myalgias, fatigue and the fever may be absent and they may show symptoms from the gastrointestinal tract, diarrhea and abdominal pain. Oxygen saturation is usually normal for children. The children are slightly ill and need less treatment, he said. In the acute phase they may have a high fever with shortness of breath and need to be introduced. According to an international study, only 1.2% of children needed to be hospitalized and only 6% of them needed to be admitted to an ICU. He stressed that although children with underlying diseases are 7 times more likely to be hospitalized, 85% of children in need of hospitalization are healthy. So, he concluded, all children are vulnerable.
ICUs in Greece have had a 30-35% mortality rate over time. This, said Anastasia Kotanidou, professor of Pulmonology and Intensive Care, director of the 1st Clinical Intensive Care at Evangelismos Hospital, brought us to a relatively good position.
We in Greece have never had the luxury of dealing with non-intubated cases which have fewer problems than the critically ill in ICU and we managed in the first wave to “have excellent survival results, which, however, began to deteriorate”, as the pressure on Health System. Greek intensivists treat the pandemic with extremely good results, despite the severe clinical picture of the patients.
The patient at home should not take medication, only antipyretics and good hydration, said Antonia Koutsoukou, professor of Pulmonology and Intensive Care, director of the First Pulmonary Clinic at Sotiria Hospital. The patient should have an oximeter and thermometer and monitor his condition three times a day. If saturation remains below 94 you should visit a hospital. As for the vitamins, said Mr. Sypsas, they do not seem to help. Newer antiviral drugs should be given 3-5 days after the onset of symptoms.
At the moment in Greece we use an algorithm for hospitalized patients, which is posted on EODY, where every doctor can see it and use it. In fact, as Mr. Sypsas said, it will be reviewed soon.
Regarding monoclonal antibodies, Mr. Loukidis said that they are not given to hospitalized patients, but for the first 5 days to patients with positive PCR. They are currently given to specific patients, but the criteria will change soon.
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